Tailoring menopause care to your patients' goals, with Jill Liss, MD

At the 2025 ACOG Annual Clinical and Scientific Meeting, Jill Liss, MD, MSCP, FACOG, associate clinical professor of OB/GYN at the University of Colorado School of Medicine, shared insights from her presentation on menopause physiology and applying evidence to patient care.

Jill Liss, MD, MSCP, FACOG, associate clinical professor, OB/GYN, at the University of Colorado School of Medicine.

Menopause as a window of opportunity

Liss emphasized the significance of the early menopause transition as a critical period for intervention. “We’re understanding a little bit more about the mechanisms within the brain, about how hot flashes, particularly, are activated in the absence of estrogen,” she said. “In the early menopause transition, when women are between ages 50 to 60 or so, there’s a real window of opportunity to act on not only menopause symptoms, but also major markers of overall health, cardiovascular health, bone health, and really take that opportunity to optimize someone's longevity.”

Clarifying safety and misconceptions of hormone therapy

“Hormone therapy is a very confusing topic, and it’s confusing for doctors and it’s also confusing for patients,” Liss stated. “But in general, the latest evidence would say that hormone therapy is safe for most people, particularly within that first 10 years after menopause.”

She noted that hormone therapy can be especially beneficial for patients with symptoms, osteoporosis risk, early menopause, or genitourinary syndrome. However, she added that caution should be used in certain populations: “We want to be careful in certain populations, certainly people with liver disease, history of breast cancer, stroke, MI, but most people, especially ages 50 to 60, will be good candidates.”

Addressing concerns about risks, said Liss, “There are two major buckets of misconception. So one being that hormone therapy is dangerous, that it causes breast cancer, cardiac issues. You know, I think really leaning on the evidence that we have, particularly, again, in that younger group of women who are symptomatic that says that it’s very safe.”

She also emphasized emerging evidence showing that symptom treatment may yield broader health benefits: “Treatment of vasomotor symptoms not only treats the vasomotor symptom or the hot flash, but actually improves parameters of health like cardiovascular health, bone health, brain health.”

Tailoring menopause care to patient goals

Liss underscored the importance of personalized care in menopause management. “Menopause is a very individual journey, and what someone wants is also very individual,” she said. “It’s really important in approaching menopause care that you take a really good history and also assess patients goals and values.”

Treatment plans, she said, should not follow a uniform protocol. “No same protocol is going to work for every patient,” she noted.

Evidence-based resources and options

For clinicians seeking guidance, Liss recommended trusted sources and a broad spectrum of treatments. “There are so many lifestyle interventions, as well as pharmacologic therapy… referencing ACOG resources, as well as the Menopause Society resources, there are tons of evidence-based things that span the spectrum.”

She added, “Cognitive behavioral therapy, diet, exercise, all of these things are fantastic. And if that’s not enough, or the patient wants more, there are both hormonal and nonhormonal options with really great resources for prescribing.”

Disclosure:

Consultant; Self; Kenvue, Bayer.

Reference:

Liss J. The Hale Lecture: Menopause Management: Understanding the Physiology and Applying the Evidence to Provide the Best in Patient-Centered Care. Presentation. Presented at: 2025 American College of Obstetricians and Gynecologists (ACOG) Annual Clinical and Scientific Meeting. May 16-18, 2025. Minneapolis, Minnesota.